Aberrant right subclavian artery associated with common carotid trunk. A rare cause of vascular ring

A right-left aortic arch pattern made up by a bicarotid trunk, a left subclavian, a left vertebral and a right retroesophageal subclavian artery

We present several vascular variations of the aortic arch vessels observed in a 35-year-old man during magnetic resonance angiography (MRA). The arterial branches of the aortic arch are from right to left: a bicarotid trunk, a left vertebral artery, a left subclavian artery, and a right retroesophageal subclavian artery. The right vertebral artery arises from the right carotid artery. Although a right retroesophageal subclavian artery has been reported in association with different anatomic variations of the aortic arch, to our knowledge this is the first MRA description of this particular combination of variations.

Aberrant Right Subclavian Artery Associated with a Common Origin of Carotid Arteries

We present a patient with a rare anomaly of the aortic arch. Angiography revealed an aberrant right subclavian artery (aRSA) originating from the middle of the aortic arch. Angiography also demonstrated an anomalous origin of the left common carotid artery sharing a common trunk with the innominate artery and a large right vertebral artery arising from the right common carotid artery. Although this particular combination of anomalies has been reported in cadaver cases, to our knowledge this is the first premortem angiographic description of a patient in which an aRSA originates from the middle of the arch between the anomalous bovine arch trunk and the left subclavian trunk.

A rare vascular ring caused by an aberrant right subclavian artery concomitant with the common carotid trunk: a report of two cases

In this report, we describe two rare cases with aortic branching anomalies. One was a 7-year-old girl who had an incomplete vascular ring caused by the presence of left aortic arch and aberrant, retroesophageal right subclavian artery associated with the common carotid trunk. The other was a 6-year-old boy who had a right aortic arch and mirror image branches of the former case. Both were asymptomatic and discovered incidentally. Three-dimensional surface rendering magnetic resonance angiography was used to confirm the diagnosis. Surgical intervention was not performed in either case because of lack of vascular ring-related symptoms. The incidence, clinical symptoms, pathogenesis and management of this rare vascular ring are discussed below.